Contrast-enhanced supplemental imaging triggers anxiety for many women
While women generally respect the need for follow-up breast imaging, their opinions regarding the available options vary widely, with some modalities conjuring more anxiety than others.
A new paper published in Insights Into Imaging details the feelings women with dense breast tissue have toward each exam used to rule out suspicious findings. According to the survey responses of 159 women, most do not hold the different options in the same regard. Authors of the new paper contend their findings could be beneficial in adapting public messaging related to supplemental imaging to better inform those who may need it.
“Patient experience and perceptions play a critical role in determining participation and overall satisfaction with breast screening programs, with fear of pain, discomfort and anxiety frequently cited as significant barriers,” Iris Allajbeu, MD, with the department of radiology at the University of Cambridge School of Clinical Medicine, and colleagues wrote. “Cultural beliefs, social norms, logistical challenges, including transportation difficulties and financial constraints, may further hinder participation in routine screening. Addressing these barriers through effective communication and tailored education is essential to bridging these gaps.”
Between January and April 2024, women participating in the BRAID (Breast Screening: Risk Adaptive Imaging for Density) trial were given a questionnaire to gauge their opinions on different supplemental exams. The questions covered abbreviated breast MRI, automated breast ultrasound and contrast-enhanced mammography. Respondents were prompted to share information regarding their perceived discomfort, anxiety and overall satisfaction for each imaging modality.
Of the 159 participants, 57 underwent ultrasound, 52 had contrast-enhanced mammography and 50 completed abbreviated MRI. Nearly 65% expressed similar sentiments for each of the modalities and traditional mammography, though 45% signaled that the supplemental exams were superior. Ultrasound and contrast-enhanced mammography were both associated with more discomfort than MRI, but CEM exams garnered the most anxiety from the majority of respondents, though the exam was generally well tolerated. CEM and MRI were linked to the most trial withdrawals, suggesting concerns and/or issues with contrasted imaging among participants.
“A significant proportion of withdrawals, many occurring before the first imaging round, were attributed to adverse physical or procedural experiences, dissatisfaction with the allocated imaging arm, or concerns regarding contrast administration or cannulation,” the authors noted. “These findings suggest that while contrast-enhanced techniques offer greater accuracy, feasible and safer alternatives like ABUS should be considered, particularly for patients with contraindications or concerns regarding contrast-enhanced modalities.”
The team suggested their findings can be used to create better experiences with contrasted imaging to encourage women not to shy away from the exams if they are well-suited for their needs.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.